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NEW CUSTOMER FORM

Thank you for becoming our customer; the form below needs to be filled by new customers.

Thank you for selecting JB Digital, LLC, fill out the requested information below and select the kiosk or service you're interested in.

Here's the link for more information on available kiosk types
Here's the link for more information on available technical services

We'll email you back to confirm your request and coordinate accordingly, depending on the kiosk or service you choose.

We only bill our customers via email once their kiosk is up and running or within 48 hours after providing technical services.
Checks are payable to JB Digital, LLC - Thank you.



Contact Name        

Business Name      

Email                    

Phone                   

Business Address   

Interested In        

Questions/Comments:


JB Digital serves Polk County, FL and surrounding areas.



If we receive incomplete information and cannot reach you to obtain missing details, the request will be discarded.

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Please let us know if you have any addtional questions!




Thank you for your business!

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